Local management of second breast cancer event after primary breast conserving therapy: The patient's perspective

Hannoun-Levi JM, Margenthaler J, Anderson B, Di Micco R, Arthur D, Aznar M, Berry MP, Brown T, Burke E, de Boniface J, Dietz J, Dodwell D, Fredriksson I, Gentilini OD, Guix B, Gutierrez C, Haidinger R, Heditsian D, Kothari A, LeStage B, Lyons J, McLean YF, MacKenzie M, Meattini I, Montero-Luis A, Mourtada F, Nguyen T, Petitti L, Polgar C, Poortmans P, Rocco N, Sackey H, Sarantou T, Showalter S, Strnad V, Kuehn T, Volders J, Vrancken Peeters MJ, Yashar C, Rubio IT, Gahm J, Zeidan Y, Kaidar-Person O, Dirbas FM (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Book Volume: 51

Pages Range: 110484-

Journal Issue: 12

DOI: 10.1016/j.ejso.2025.110484

Abstract

BACKGROUND: In case of a second ipsilateral breast cancer event (2ndiBCE) after primary breast conserving treatment (BCT), patients are offered salvage mastectomy (SM) or, for selected patients, 2ndBCT. An international survey dedicated to breast cancer survivors investigated patients' preferences and expectations. METHODS: An international survey was drafted jointly with breast cancer patient advocates from the United States (n = 6) and Europe (n = 2). The survey was validated with 33 questions divided into four themes: demographic data, oncological outcomes, patient views and financial issues. The survey was sent to breast cancer survivors. All information provided was anonymized. RESULTS: From 06/24 to 10/24, 105 patients answered the online survey. The common patient profile was a white (76 %), married (61.5 %), Christian (58.8 %), US-resident (70.2 %) woman aged between 61 and 70 (62.2 %). Long-term outcomes were perceived as being well established for SM (51.5 %) and 2ndBCT (17.1 %). Breast re-irradiation was considered at risk of complications (65.7 %), and 63 % of the patients thought that 2ndBCT provides a more acceptable body self-image. 2ndBCT was expected to give superior cosmetic outcomes than SM with breast reconstruction (55.4 %). Having enough information and ample time to consider the pros and cons of treatment options were very important/important for 99 % and 96.2 %, respectively. Treatment choice was not influenced by financial concerns for 68.3 %. CONCLUSION: Patient perspective is very important in the decision-making process regarding salvage treatments. Physicians must provide clear, timely information which will enable patients to choose the treatment that best meets their expectations.

Authors with CRIS profile

Involved external institutions

Karolinska Institute Sweden (SE) National Coalition for Cancer Survivorship (NCCS) United States (USA) (US) Westchester Medical Center University Hospital (WMC) United States (USA) (US) Clínica Universidad de Navarra Spain (ES) Virginia Commonwealth University (VCU) United States (USA) (US) Universitat de Barcelona (UB) / University of Barcelona Spain (ES) University of California San Francisco (UCSF) United States (USA) (US) Stanford University United States (USA) (US) Diakonessenhuis Utrecht Netherlands (NL) Breast Cancer Care and Research Fund (BCCRF) United States (USA) (US) Università Vita-Salute San Raffaele (UniSR) Italy (IT) Universität Ulm Germany (DE) Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI / NKI-AVL) Netherlands (NL) University of Côte d'Azur / Université Côte d'Azur France (FR) University of Manchester United Kingdom (GB) University of Oxford United Kingdom (GB) Guy's and St Thomas' (NHS Foundation Trust) United Kingdom (GB) Harvard University United States (USA) (US) Catalan Institute of Oncology / Institut Català d'Oncologia (ICO) Spain (ES) Sidney Kimmel Cancer Center – Jefferson Health United States (USA) (US) University of Wisconsin - Madison United States (USA) (US) Ospedale San Raffaele (früher: Centro San Raffaele del Monte Tabor Foundation) Italy (IT) University of Kentucky United States (USA) (US) New York University (NYU) United States (USA) (US) Baptist Health South Florida United States (USA) (US) University Hospitals of Cleveland / Case Western Reserve University Hospital United States (USA) (US) University of California, San Diego (UC San Diego, UCSD) United States (USA) (US) HM Hospitals Spain (ES) Országos Onkológiai Intézet / National Institute of Oncology Hungary (HU) University of Alabama at Birmingham (UAB) United States (USA) (US) Independent Cancer Patients' Voice (ICPV) United Kingdom (GB) Università degli Studi di Napoli Federico II Italy (IT) Chaim Sheba Medical Center at Tel HaShomer / המרכז הרפואי עש חיים שיבא – תל השומר‎‎ Israel (IL) University of Virginia (UVA) United States (USA) (US) University of Antwerp / Universiteit Antwerpen Belgium (BE) Atrium Health United States (USA) (US) Università degli Studi di Firenze / University of Florence Italy (IT)

How to cite

APA:

Hannoun-Levi, J.M., Margenthaler, J., Anderson, B., Di Micco, R., Arthur, D., Aznar, M.,... Dirbas, F.M. (2025). Local management of second breast cancer event after primary breast conserving therapy: The patient's perspective. European Journal of Surgical Oncology, 51(12), 110484-. https://doi.org/10.1016/j.ejso.2025.110484

MLA:

Hannoun-Levi, Jean Michel, et al. "Local management of second breast cancer event after primary breast conserving therapy: The patient's perspective." European Journal of Surgical Oncology 51.12 (2025): 110484-.

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